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Inicio Gastroenterología y Hepatología (English Edition) Hepatitis B and C screening in hospitalized patients with SARS-CoV-2 infection
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Vol. 45. Issue 4.
Pages 256-264 (April 2022)
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Vol. 45. Issue 4.
Pages 256-264 (April 2022)
Original article
Hepatitis B and C screening in hospitalized patients with SARS-CoV-2 infection
Cribado de infección por virus de la hepatitis B y C en pacientes hospitalizados con infección por SARS-CoV-2
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Judith Gómez Camareroa,
Corresponding author
jgomcam@hotmail.com

Corresponding author.
, Ester Badia Arandaa, Raisa Quiñones Castrob, Rosa María Saiz Chumillasa, Laura Alcoba Vegab, Sandra Díez Ruizb, Noemí Gómez Maneroc, Raquel Vinuesa Campoa, Francisco Jorquera Plazab,d,e
a Servicio de Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain
b Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, León, Spain
c Servicio de Medicina Interna, Hospital Universitario de Burgos, Burgos, Spain
d Instituto Universitario de Biomedicina (IBIOMED), Universidad de León, León, Spain
e Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
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Table 1. Characteristics of HBsAg-positive patients.
Table 2. Characteristics of patients positive for anti-HCV antibodies.
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Abstract
Aims

To evaluate the results of a hepatitis B and C screening program in hospitalized COVID-19 patients.

Method

Transversal prospective study conducted in two Spanish hospitals. Patients admitted from March 1st to December 31st 2020 with a diagnosis of COVID-19 were tested for markers of hepatitis B (HBsAg, anti-HBc) and C (anti-HCV, HCV RNA) infection.

Results

In this period, 4662 patients with COVID-19 were admitted to our centers: 56.3% were male, median age was 76 (0–104) years. Data regarding HBV infection was available in 2915 (62.5%) patients; 253 (8.75%) were anti-HBc + and 11 (0.38%) HBsAg+. From these, 4 patients did not have a previous diagnosis of hepatitis B, 7 received corticosteroids and one received prophylaxis. There was one HBV reactivation. Anti-HCV were available in 2895 (62%) patients; 24 (0.83%) were positive. From these, 13 patients had a previous hepatitis C diagnosis: 10 patients had been treated with SVR, one achieved spontaneous cure and 2 did not receive treatment. From the 11 previously unknown anti-VHC + patients, 10 had a negative HCV RNA. Overall, only 3 (0.10%) patients tested RNA HCV + . However, none received HCV treatment (2 older than 90 years with comorbidities, 1 died from COVID-19).

Conclusion

Screening of hepatitis C infection in hospitalized COVID-19 patients seems less useful than expected. The low prevalence of active infection after antiviral treatments and the high age of our population limit the detection of potential candidates for treatment. HBV screening should be aimed to prevent reactivation under immunosuppressive treatments.

Keywords:
Hepatitis B
Hepatitis C
Screening
COVID-19
SARS-CoV-2
Resumen
Objetivo

Evaluar el resultado del cribado de hepatitis B y C en pacientes ingresados con COVID-19.

Pacientes y métodos

Estudio transversal, prospectivo, realizado en dos hospitales españoles de tercer nivel. Se estudiaron marcadores de hepatitis B (HBsAg, anti-HBc) y C (anti-VHC, ARN VHC) a todos los pacientes hospitalizados con COVID-19 del 1 de marzo al 31 de diciembre de 2020.

Resultados

En este periodo ingresaron 4662 pacientes con COVID-19: 56,3% fueron varones, la edad mediana fue 76 (0–104) años. Se realizó serología de hepatitis B a 2915 (62,5%) pacientes; 253 (8,75%) presentaban anti-HBc + y 11 (0,38%) HBsAg+. De los 11 pacientes, 4 desconocían el diagnóstico, 7 recibieron esteroides y uno recibió profilaxis. Hubo un caso de reactivación del VHB. Se determinaron anticuerpos anti-VHC a 2895 (62%) pacientes; 24 (0,83%) fueron positivos. De ellos, 13 pacientes estaban diagnosticados: 10 habían recibido tratamiento, uno se había curado espontáneamente y dos no habían sido tratados. De los 11 restantes, 10 tenían ARN VHC indetectable. En total, sólo 3 (0,10%) pacientes tenían carga viral detectable. Sin embargo, ninguno recibió tratamiento (2 > 90 años con comorbilidades, 1 falleció por COVID-19).

Conclusiones

El cribado de hepatitis C en pacientes ingresados por COVID-19 en nuestro medio ha mostrado menor utilidad de la esperada. La baja prevalencia de infección activa tras los tratamientos antivirales y la alta edad mediana de nuestra población limitan la detección de potenciales candidatos a tratamiento. El cribado de hepatitis B debería dirigirse a prevenir la reactivación en pacientes que precisen tratamientos inmunosupresores.

Palabras clave:
Hepatitis B
Hepatitis C
Cribado
COVID-19
SARS-COV-2

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